| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | KAISER FOUNDATION HEALTH PLAN INC. | $203K | $8K | $211K | 2.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | HEALTH NET | $175K | — | $175K | 2.14% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $97K | $8K | $105K | 12.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $44K | $3K | $47K | 5.37% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS, INC. | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 0.25% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 0.19% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $82K | $7K | $89K | 11.56% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $40K | $2K | $42K | 5.51% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $31 | $3K | 0.39% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS INC. | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $427 | — | $427 | 0.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | DELTA DENTAL OF CALIFORNIA | $24K | — | $24K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMNITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $29K | $6K | $34K | 12.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | DELTA DENTAL OF CALIFORNIA | $27K | — | $27K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | EYEMED VISION CARE | $24K | — | $24K | 9.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $1K | $8K | 12.85% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 1,917 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,921 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 2,738 | $18.6M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 913 | $879K |
| Vision | EYEMED VISION CARE | 3,472 | $250K |
| Life insurance(3 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 2,329 | $1.2M |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 2,329 | $866K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 2,738 | $18.6M |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,632 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,472 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
No prospect flags tripped on this filing.